Higher deaths linked to A&E waiting times

Improvements will be carried out at the Shropshire’s accident and emergency departments after a report showed deaths in A&E were three times the national average during a period in 2022.

Shrewsbury and Telford Hospital NHS Trust(SaTH) delivered a report to directors investigating a “cluster” of 140 deaths in emergency departments between October and December 2022, up from 75 the previous year.

The trust said the increase coincided with an increase nationally during the same period, although it admitted the rise was greater than the national average, during a prepared response to member questions during a meeting of Shropshire Council’s Health Overview and Scrutiny Committee.

In the response, they say they have introduced a number of improvements as a result of the review, including the opening of new recovery wards at both Telford’s Princess Royal and the Royal Shrewsbury hospitals, as well as improved escalation processes and emergency hospital protocols designed to kick in at times of sustained pressure on A&E services.

“Shrewsbury and Telford Hospital NHS Trust carried out a review of the increased deaths noticed in Q3 of 2022/23 in emergency departments. The review did not identify any overall failures or omissions in medical or nursing care that were considered to have adversely impact the outcomes for patients,” they said.

“Although a greater proportion of the admitted time in hospital is now within the ED(Emergency Department) footprint due to system pressures in UEC(Urgent and Emergency Care) this can only partly explain the rise.

“The report concluded in line with published evidence that the increased deaths within the ED were likely to have been in part related to the increased length of stay within ED. This was likely to have had the greatest impact on older frailer patients. ”

The annual figures showed there were 404 deaths in Shropshire’s emergency departments in 2022/23, of which 163 were referred to the coroner.

Other mitigations introduced in January include measures to improve assessment times in emergency departments and a review of support models for patients identified as being frail.

NHS Shropshire Director for Delivery and Transformation, Gareth Robinson said the trust had ramped up capacity with the provision of additional A&E beds to ease pressures over the busy Christmas period, and the opening of the two new wards would eventually provide an extra 46 beds for patients who were recovering from acute trauma.

A total of 40 “sub-acute” beds are now open with a further 6 beds to be provided at Shrewsbury following the completion of building works.

“The rehabilitation units are now both open and fully functional. The first one came on stream on January 2 opening 20 beds at Princess Royal Hospital Telford,” he said.

“The second set of 20 beds [in Shrewsbury] were due to open on January 15 and they were pulled forward by approximately a week… so that gives us 40 additional beds into the system.

“It’s an excellent way of providing the correct pathway for patients back to where they’re best cared for in their original place of residence.

“On top of that there’s a raft of work around the expansion of virtual wards, the role of rapid response units and the increased capacity that we’re seeing within complex discharges through social care packages, so I’m really comfortable that the capacity that’s coming from this area has been a real boon to the system.”